Marone Gianni, Bova Maria, Detoraki Aikaterini, Onorati Anna Maria, Rossi Francesca W, Spadaro Giuseppe
Department of Clinical Immunology and Allergy, University of Naples Federico II, School of Medicine, Via S. Pansini 5, 80131 Naples, Italy.
Novartis Found Symp. 2004;257:133-49; discussion 149-60, 276-85.
Human mast cells, by elaborating vasoactive mediators and cytokines, are the primary effector cells of anaphylaxis. A body of evidence implicates human heart mast cells (HHMCs) in anaphylaxis. These cells have been identified perivascularly, in dose proximity to myocytes and in the arterial intima in human heart tissue. The membrane surface of mast cells from human heart tissue of patients undergoing cardiac transplantation expresses the high affinity receptors for IgE (FcepsilonRI) and C5a receptors. Activation of HHMCs in vitro with anti-IgE or anti-FcepsilonRI induced the release of preformed mediators (histamine, tryptase and chymase) and the de novo synthesis of LTC4 (approximately equal to 18 ng/10(6) cells) and PGD2 (approximately equal to 18 ng/10(6) cells). Complement activation and anaphylatoxin formation occur during anaphylaxis in human. C5a caused rapid release of histamine and tryptase from HHMCs. These cells are activated in vitro by therapeutic (general anaesthetics, protamine, etc.) and diagnostic agents (radio contrast media, etc.) that may cause non-IgE-mediated anaphylactic reactions. Administration of low concentrations of histamine and cysteinyl leukotrienes in subjects undergoing diagnostic catheterization caused significant systemic and coronary haemodynamic effects. Taken together, these results indicate that the human heart can be both the site and the target of anaphylactic reactions.
人类肥大细胞通过分泌血管活性介质和细胞因子，成为过敏反应的主要效应细胞。大量证据表明人类心脏肥大细胞（HHMCs）参与过敏反应。这些细胞已在人体心脏组织的血管周围、靠近心肌细胞处以及动脉内膜中被识别出来。接受心脏移植患者的心脏组织中的肥大细胞膜表面表达IgE高亲和力受体（FcepsilonRI）和C5a受体。用抗IgE或抗FcepsilonRI在体外激活HHMCs会诱导预先形成的介质（组胺、类胰蛋白酶和糜蛋白酶）释放以及白三烯C4（约等于18 ng/10⁶个细胞）和前列腺素D2（约等于18 ng/10⁶个细胞）的从头合成。补体激活和过敏毒素形成在人类过敏反应过程中发生。C5a导致HHMCs迅速释放组胺和类胰蛋白酶。这些细胞在体外可被可能引起非IgE介导过敏反应的治疗药物（全身麻醉剂、鱼精蛋白等）和诊断试剂（放射性造影剂等）激活。在接受诊断性导管插入术的受试者中给予低浓度组胺和半胱氨酰白三烯会引起显著的全身和冠状动脉血流动力学效应。综上所述，这些结果表明人类心脏既可以是过敏反应的发生部位，也可以是过敏反应的靶器官。
